In total there were 1,343 children aged under 16 who underwent this treatment last year compared to just 193 four years earlier.

Most of the centre’s child patients last year were secondary school aged children who were 12 to 16, but the proportion of younger children among the Centre’s patients has increased in the last two years.

Experts believe there are more referrals because society is becoming much more tolerant and aware of gender identity issues.